AFib Sub-Analysis of ARISTOTLE Trial Finds Direct Association Between Digoxin and Risk of Death

Digoxin (Lanoxin/GlaxoSmithKline) is used primarily to treat heart failure but is also used for atrial fibrillation (AFib) to control the heart rate. The medication became a controversial topic in recent years as several studies have questioned its safety, and even found that digoxin could increase the rate of death in people with AFib.

Using the database from the 40-country, double-blind phase 3 ARISTOTLE study, which has been around for over 5 years, a sub-analysis was conducted by Renato Lopes, MD, PhD, professor of Medicine at Duke University in Durham, North Carolina and colleagues. ARISTOTLE compared apixaban and warfarin in patients with AFib and an increased risk of stroke. Lopes broke down the results with MD Magazine at the 66^th Scientific Session of the American College of Cardiology (ACC 2017) in Washington, District of Columbia.

The team used baseline analysis and incidence analysis to determine how digoxin impacts patients.

“When we looked at the digoxin concentration as a continuous variable as opposed to different cutoffs, we found a 90% increase in the risk of death for each 0.5 ng/mL increase in serum digoxin concentration,” Lopes said.

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